Advanced cancer

A diagnosis of advanced cancer can be very hard to understand and accept. If you or someone you love has been diagnosed with advanced cancer, you may feel overwhelmed, like you can’t take it all in or that it’s just a bad dream. You might not be sure that you understand what the doctor meant. Advanced cancer is defined as cancer that is unlikely to be cured. Healthcare professionals may also use the terms secondary, metastatic, terminal or progressive cancer to describe it.

Most people living with advanced cancer experience a wide range of feelings and emotions as they come to accept the diagnosis. These feelings can be overwhelming at first, but most become more manageable as you get used to the diagnosis and start to make plans and decisions.

Shock and disbelief – It’s difficult to hear that cancer can’t be cured, and you may not want to believe what you’ve been told. Many people say they feel numb or like they’re walking around in a fog.

Anger – It’s normal to feel angry and frustrated. Your anger could be directed anywhere. You might feel angry with the person who has told you the treatment hasn’t worked. You might also direct your anger at your family and friends. Some people question their faith.

Sadness, loneliness and isolation – Finding out you or someone you love has advanced cancer usually leads to a deep sense of loss. While family and friends may want to be close to you, you may not feel like you want to be around people as you come to terms with the diagnosis. You may feel isolated, as if no one could possibly understand what you’re going through.

Guilt – Some people diagnosed with cancer feel guilty for leaving loved ones behind or causing sorrow. Some people worry that they should have gone to the doctor earlier or fought harder against the disease. Loved ones may feel guilty that they haven’t done enough.

Fear – It’s normal to feel very scared of advanced cancer. People with advanced cancer may fear:

being in pain and suffering

being left alone or dying alone

becoming a burden

losing control of the body and needing others’ help

losing dignity

the unknown and the future

leaving loved ones behind

Moving forward

Accepting the diagnosis and adjusting to life with advanced cancer often takes time. Acceptance doesn’t mean giving up. Rather, acceptance allows you to take control of your life and focus on what’s most important to you. Many people find that as they become more accepting of the situation, some positive feelings help to balance the difficult emotions.

As you move forward, you may connect more deeply with people in your life, spend more time with them and tell them how important they are to you. Some people go back to visit places that had special meaning in their life or go on a trip they’ve wanted to take for many years. You may try to talk to or visit old friends that you have lost contact with over the years. You may want to heal a relationship that has been difficult or awkward, clear up past arguments or misunderstandings and talk about hurt feelings to find peace with someone again.

Some people find it helpful to do a life review, which means looking back on your life and perhaps talking about it with another person. This can be an important part of remembering the many ways in which your life has meaning and value. Life reviews can be hard work. They take honest and deep reflection on who you are and how you came to be that person.

For some people, being diagnosed with cancer leads to spiritual discovery. This deeply personal process may continue or change when you have advanced cancer.

There is no way of knowing or predicting how long someone will live with advanced cancer. Some people may live much longer than expected, while others may die sooner than expected. Doctors may be able to guess at a timeline based on what they know about a person and the type of cancer, but it’s not an exact science.